Provider Demographics
NPI:1275943169
Name:TORRES, RENE
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4118
Mailing Address - Country:US
Mailing Address - Phone:956-361-5009
Mailing Address - Fax:956-361-4539
Practice Address - Street 1:320 N WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4118
Practice Address - Country:US
Practice Address - Phone:956-361-5009
Practice Address - Fax:956-361-4539
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04956363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant